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Review |
,
From the * Department of Biochemistry and Urology,
Boston University School of Medicine, Boston, Massachusetts;
Bayer-Schering Pharma, Men's Healthcare,
Berlin, Germany; Gulf Medical College School
of Medicine, Ajman, UAE; and the Department of
Endocrinology, Center for Sexual Function, Lahey Clinic, Peabody,
Massachusetts.
| Correspondence to: Dr Abdulmaged M. Traish, Professor of Biochemistry and Urology, Director, Laboratories for Sexual Medicine, Institute for Sexual Medicine, Boston University School of Medicine, Center for Advanced Biomedical Research, 700 Albany St, W607, Boston, MA 02118 (e-mail: atraish{at}bu.edu). |
A considerable body of evidence exists suggesting that androgen deficiency
contributes to the onset, progression, or both of cardiovascular disease
(CVD). The aim of this review is to evaluate the relationships between
testosterone (T) deficiency and risk factors of CVD and to discuss the
implications of androgen deficiency in men with cardiovascular risk factors.
The relationship between androgen deficiency and endothelial function, lipid
profiles, inflammatory responses, altered vascular smooth muscle reactivity,
and hypertension are discussed with regard to CVD. A comprehensive literature
search was carried out with the use of Pub Med from 1980 through 2009, and
relevant articles pertinent to androgen deficiency and vascular disease were
evaluated and discussed. Low T, whether attributed to hypogonadism or androgen
deprivation therapy, in men with prostate carcinoma, produces adverse effects
on cardiovascular health. Androgen deficiency is associated with increased
levels of total cholesterol, low-density lipoprotein, increased production of
proinflammatory factors, and increased thickness of the arterial wall and
contributes to endothelial dysfunction. Testosterone supplementation restores
arterial vasoreactivity; reduces proinflammatory cytokines, total cholesterol,
and triglyceride levels; and improves endothelial function but also might
reduce high-density lipoprotein levels. Testosterone is an anabolic hormone
with a wide range of beneficial effects on men's health. The therapeutic role
of T in men's health, however, remains a hotly debated issue for a number of
reasons, including the purported risk of prostate cancer. In view of the
emerging evidence suggesting that androgen deficiency is a risk factor for
CVD, androgen replacement therapy could potentially reduce CVD risk in
hypogonadal men. It should be emphasized, however, that androgen replacement
therapy should be done with very thorough and careful monitoring for prostate
diseases.
Key words: Androgen deficiency, endothelial dysfunction, metabolic syndrome
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